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71 Cards in this Set
- Front
- Back
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What are treatments for laminitis are always indicated
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Corrective trimming
Support of sole surface Cautious use of phenylbutazone Dedicated nursing care |
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What are other drug treatments for laminitis
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Low dose acepromazine
Topical DMSO Local nitroglycerine |
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What are other non drug treatments for laminitis
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Special horse shoes
Section of distal accessory ligament Coronary grooving Hoof Wall resection Denervation of the foot |
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True or False acute laminitis must be treated as an emergency
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TRUE
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What is the long term prognosis of acute laminitis
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Favorable if the signs resolve in less then a week
(may be at a greater risk for laminitis in the future |
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What does the prognosis for chronic laminitis depend on
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How well the horse tolerates pain
Amount of P3 deviation Skill and knowledge of the farrier Owner interest and dedication |
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What are negative prognosticators for laminitis
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Horse cant stand for much of the day
Owner will not attend or can't afford the cost of treatment Perforation of the sole by P3 Sinkers have an unfavorable prognosis |
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What is better for laminitis heating or cooling the foot
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UNKNOWN
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What are the basic treatment recomendations for chronic laminitis
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Turn out on soft pasture or deep bedding
Reduce exercise requirement to a resonable minimum note horse should not be confined to a stall all day or forced to move faster then it wants to Desmotomy of the distal accessory ligament Corrective trimming of gradual removal of dorsal toe and heel Minimum effective dose of phenylbutazone per os |
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What are advanced treatment recommendations for chronic laminitis
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Change from phenylbutazone to a safer NSAID (only if effective)
Adjustable heart bar shoe Coronary grooving Nitroglycerine cream applied to palmar pastern Tenotomy of deep digital flexor tendon Hoof wall resection Cryoneurectomy |
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Where do cattle usually get laminitis
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Lateral hind claws
Usually chronic |
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What are diagnostic features of bovine laminitis
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Abnormal overgrowth of hoof
Characteristic gait and stance |
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True or False hindlimb laminitis is often mistaken for colic
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True
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Where does acute laminitis occur in the bovine
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Front limbs
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Where does chronic laminits occur in the bovine
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Hind Limbs
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If a horse has laminitis where is it seen first
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Always seen first in the forelimbs
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What is the pathophysiology of acute laminar degeneration
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Trigger event -> increased matrix metalloproteinase in lamellar basement membrane -> weakened basement membrane -> microscopic tearing and seperation of sensitive and insensitive laminae-> leads to vascular changes A-V shunt and ischemic necrosis
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What are risk factors for laminitis
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Severe gram neg infections
Pleuritis, metritis, grain overload Metabolic disease (equine Cushing's) Corticosteroid therapy Chronic contralateral lameness Plant and other toxins (Black walnut shavings) Lush grass and other hot feed |
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How is ALD diagnosed
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Characteristic lameness
Standing posture weight is shifted to hindlimbs Presence of known risk factors Strong pulse in palmar digital arteries (hypertension) Warm hoof Sensitive to hoof testers at toe Lameness blocks out at Abaxial sesamoid |
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What is the treatment for laminitis
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Radiograph of both front feet to R/O pre-existing disease
Systemic NSAID Sole support, soft rubber, plaster, styrofoam, caulk Low diet - no grain, grass only Vasodilators Dub toe Heating/cooling ????? |
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What are factors for a favorable prognosis of laminitis
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Inciting cause is a brief event
Early reduction of lameness No signs on day 3 |
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locus, -i (loca, locorum n. pl.) (m.)
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place
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What are signs of chronic laminar degeneration
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Lameness pain is unrelenting
Hoof capsule is deformed Gross seperation of laminae has occurred and may be continuing Often accompanied by related problems -hoof abscess, poor hoof quality, weight loss |
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What are treatments for chronic laminitis
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NSAID every day
Other analgesic methods Deep soft bedding Weight reduction Minimum activity Frequent corrective trimming, shoes Deep digital flexor tenectomy or DAL desmotomy |
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What is the prognisis for chronic laminitis
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Never better then guarded
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What does the prognosis for chronic laminitis depend on
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Pain tolerance of horse
Owner dedication Skill and experience of farrier P3 position and movement |
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What are the parameters for prognosis with movement of P3
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<6 degrees favorable with treatment
6 - 12 degrees guarded > 12 degrees unfavorable |
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when do you see laminitis in ruminants
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May occur in any ruminant with grain overload
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True or False laminitis is an infrequent reason for culling in dairys
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TRUE
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What is laminitis associated with in cattle
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A feed associated problem in high producing dairy cows
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What is the treatment for acute laminitis in a nutshell
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Diagnose and treat underlying cause
NSAID Restrict movement and have a soft surface |
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What is the treatment for chronic laminitis in a nutshell
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Frequent corrective trimming
NSAID Attention to hoof infections |
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What are the frequent conditions of the foot
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Sole bruise - impact injury
Quicking - Horseshoe nail too close Thrush - superficial infection Deep hoof infections (abscess) Hoof wall cracks - too dry, hard use Shelly hooves - poor quality hoof |
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What are the infrrequent conditions of the hoof
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Quittor - chronic infection of digital cartilages
Canker - proliferative pododermititis of the frog Keratoma - benign tumor of the hoof Sheared heels - growth abnormality White line disease - fungal infection? |
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What causes Shelly hooves
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Nutrition is blamed but most likely environment is the cause
Lack of exercise, standing in wet conditions, poor hoof trimming Some horses have weak hooves |
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Why are sole bruises important
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Because they are a differential for fractures or infections
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What is a sole bruise
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Peracute, brief, severe lameness
Mostly seen in horses |
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What is effective treatment for a sole bruise
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A moon boot
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What are the causes of hoff infections
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Thrush, hoof/foot rot - external exposure in a wet environment
Sole punctures Hematogenous: bacteremia with concurrent damaged laminae Gravel: gradual entry of dirt forced up a tract through the hoof laminae |
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What are some common bacterial agents of hoof infections
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Fusobacterium necrophorum
Bacteroides corrodens |
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What are the characteristics of a sole abscess
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Infections are usually anaerobic, focal, and close to the sole
Local inflammation, though small, is very painful and peracute, severe lameness results |
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How is a hoof infection diagnosed
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Visual inspection, hoof testers
Abaxial sesamoid nerve block Rads for persistant cases Discovery with a knife or drill Occult abscesses can be missed for weeks |
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What are some sequelae of hoof infections
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Prolonged lay up for hoof to grow
Formation of chronic hoof ulcers Invasion of DIP joint |
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How are hoof infections treated
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Ventral drainage is curative - make BIG hole in the sole
Bandaging provides analgesia, protection of the hoof excavation Antibiotics may help the horse more then the cow |
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How are hoof infections treated in cattle
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Claw amputation
Salvage procedure with good prognosis |
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Who gets interdigital fibromas
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English breed bulls
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How do interdigital fibromas present
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Pain on weight bearing (pinching)
Loss of breeding effeciency Often bilateral |
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How are interdigital fibromas treated
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Surgical removal is curative
Skin is bandaged, not sutured Wire toes together for weeks |
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What is palmer heel pain due to
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Navicular disease and everything else
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How does navicular disease typically present
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Insidious onset
Stumbling in pasture Short choppy stride Walking on eggs Horse may warm out of the lameness |
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Who is associated with navicular disease
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Associated with short heavy types, small feet and stock breed horses
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What is the function of the navicular bone
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Afford additional leverage and gliding function to the DDF
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How is navicular disease diagnosed
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It is a CLINICAL IMPRESSION of characteristic gait withimprovement with a PD regional anesthesia
Rads should have characteristics which support the diagnosis |
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What are some general treatments for navicular disease
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Hoof care and specialized shoes
Management alterations NSAIDS Surgical neurectomy |
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What are the complicatrions of a surgical neurectomy
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Neuroma formation
Rupture of DDF tendon Abscess |
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What signs are indicitive of a P3 fracture
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Acutre lameness w/o other explanation
Reduction in lameness in first week then persisting Painful responce to hoof testers Blocks out with abaxial sesamoid |
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True or False most P3 fractures dont appear radiographically until 10 days post injury
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TRUE
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Why is the prognosis for orthapedic infection worse in foals
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Because of the risk of failure of passive transfer
Frequent involvement of multiple joints And the presence of osteomyelitis iin 50% of the cases |
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What is the most common origin of orthapedic infections in foals
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Hematogenous spread
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How can successful resolution of orthapedic infection be enhanced
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Early diagnosis
Aggressive treatment |
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What are the early signs of orthapedic infection in the foal
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Joint enlargement
Heat Pain associated reluctance to rise or bear weight |
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What are early signs of orthapedic infection in the adult horse
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May be non-weight bearing
Or very lame IV-V/V |
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What are differential diagnoses for orthapedic infection
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Solar abscess
Severe acute soft tissue injury Fractures Septic arthritis Septic tenosynavitis |
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What should be examined on a blood profile with foals suspected with orthapedic infection
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Fibrinogen levels
Gamma globulin levels |
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What are the parameters for considering a joint septic
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Synovial fluid cell count > 30 X 109/L (Normal < 5 X 109/L)
Total protein > 4 g/dL (Normal <2 g/dL) |
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What is the most likely organism involved with septic foals and in penetrating wounds in adults
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Enterobacteriaceae
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What is the most likely organism indicated post synovial injection or surgery
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Staphylococcal
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What is the treatment for septic joints
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Synovial drainage, debridement and lavage
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What is the biggest issue of fibrin within the joint
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It provides a place for bacteria to be harbored
May contribute to inflammatory process May contribute to intra-articular adhesions |
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List the treatment options for orthapedic infections
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Synovial drainage, lavage and debridement
Systemic antimicrobials Anti-inflammatory medication Analgesia PMMA impregnated with antibiotics Biodegradable antimicrobial delivery systems Regional limb defusion Intrasynovial injection of antibiotics Arthrodesis, facilitated ankalosis and bone resection |
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What conditions characterise traumatically induced joint disease
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Synovitis
Capsulitis Articular cartilage and bone fragmentation or fracture Ligament tearing Osteoarthritis |
